In May 2000, Virginia Commonwealth University Medical Center opened an 11-bed palliative-care unit that has become a model for other US hospitals. Slow to gain acceptance in the US, palliative care has been a recognized medical specialty in Britain since 1987. Palliative-care physicians focus on comfort rather than cure when treating terminally-ill patients. Although they use procedures such as blood transfusions and radiation to treat symptoms of a disease, palliative-care physicians do not use all the drugs and technology at their disposal "to preserve life at any cost." Like hospice care, palliative care emphasizes pain management and easing mental-emotional stress. Palliative care, however, can begin earlier than hospice.
VCU's palliative care unit exemplifies its humane as well as economic advantages. In order to increase the comfort of cancer patients who suffer shortness of breath, the unit's physicians developed a 'misting device' that delivers pain medication directly to the lungs. The palliative-care doctors are also more comfortable prescribing strong narcotics, such as Dilaudid, to help patients suffering from intense pain. The staff goal is that patients can die peaceably in the familiar comfort of their own home, if possible. In the process, the palliative-care unit saves millions of dollars. The Wall Street Journal compared the average care cost for terminally-ill cancer patients during the five days before dying in a palliative vs. a non-palliative unit. Drugs and chemotherapy, lab tests and diagnostic imaging, medical supplies, room, and other expenses average $12, 319 for five days of care in a non-palliative unit. The average cost in the palliative unit is $5,312. Non-palliative care involves far more lab testing and drug treatment--even though a patient is near death--than palliative care. Right now, about 50% of Americans who die each year die in a non-palliative hospital unit.
Naik, Gautam. Unlikely Way to Cut Hospital Costs: Comfort the Dying. The Wall Street Journal 10 March 2004.
COPYRIGHT 2004 The Townsend Letter Group
COPYRIGHT 2004 Gale Group
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